If you are experiencing thoughts of suicide, you are not alone and help is available. At Cura Mind and Wellness, patients across the Houston metro receive evidence based, respectful care that reduces risk and restores hope. We provide in person visits in Richmond, TX and secure telepsychiatry across Houston and Fort Bend County.
Care is directed by Vivian Emuobe, MSN, BSN, APRN, PMHNP-BC, a board certified psychiatric mental health nurse practitioner with extensive inpatient and outpatient experience in mood disorders, trauma, and crisis stabilization.
If you ever feel at imminent risk, go to the nearest emergency department or call local emergency services immediately.
Understanding suicidal ideation
Suicidal ideation refers to thoughts of wanting to die, from fleeting wishes to more specific planning. These thoughts can be symptoms of depression, bipolar disorder, PTSD, substance use, or overwhelming stress. While frightening, they are treatable.
Myths and facts
- Myth: Asking about suicide makes it worse. Fact: Direct, compassionate conversation reduces risk.
- Myth: People who talk about suicide won’t act. Fact: Most people who die by suicide show warning signs first.
- Myth: Nothing can help. Fact: Therapy, medication, and safety planning save lives.
Warning signs we evaluate
- Hopelessness or feeling like a burden,
- Withdrawal from family, friends, or work,
- Risky behaviors such as reckless driving or substance use,
- Saying goodbye or giving away possessions,
- Major changes in sleep or appetite,
- Severe anxiety, agitation, or mood swings.
Our evaluation approach
Every visit begins with a comprehensive, respectful intake:
- Current risk, presence of thoughts, intent, and safety concerns,
- Mental health review, depression, anxiety, trauma, ADHD, psychosis, or bipolar spectrum,
- Medical contributors, pain, thyroid, or medication side effects,
- Substance use screening, alcohol or drugs that worsen risk,
- Support system review, trusted relationships and community ties,
- Shared goals, what safety and stability look like today and in the next month.
Outcomes include an immediate safety plan, follow up schedule, and treatment roadmap. If outpatient care is not appropriate, we coordinate urgent or inpatient care.
Safety planning
We use a structured, personalized plan patients can keep with them:
- Warning signs and early cues,
- Coping skills that lower distress,
- Social settings or activities for distraction,
- Supportive people to contact,
- Professional and urgent care options,
- Means safety steps to reduce access to lethal methods.
The plan is reviewed and updated at each visit.
Therapy for suicidal ideation
- CBT for Suicide Prevention, CBT-SP, teaches patients to reframe hopeless thoughts and build problem solving skills,
- Dialectical Behavior Therapy, DBT, builds emotion regulation, distress tolerance, and crisis survival skills,
- CAMS model, a collaborative framework that centers patient goals,
- Trauma informed therapy, for patients with PTSD or complex trauma driving suicidal thoughts.
Telehealth provides flexibility for Houston patients, with in person sessions in Richmond when closer support is best.
Medication support
Medication can reduce symptoms that drive suicidal thoughts. Options may include:
- Antidepressants for depression, monitored carefully for safety,
- Mood stabilizers for bipolar spectrum disorders,
- Targeted sleep or anxiety medications when needed,
- Pharmacogenomic gene testing at our Richmond office for patients with prior side effect issues or poor response.
Medication decisions are conservative, collaborative, and paired with therapy.
Advanced treatment options
When suicidal thoughts are tied to treatment resistant depression, we may consider:
- TMS therapy, available in Richmond for depression and OCD, proven to reduce severity and improve safety,
- IV ketamine, carefully selected for severe, resistant depression, not used if psychosis is present.
These options are always integrated with therapy and close follow up.
Family and partner involvement
With your consent, we educate loved ones on how to provide safe, supportive care. We coach communication, stress reduction, and boundaries that lower conflict while increasing connection.
The Houston context, making plans practical
Patients in Houston face unique stressors, including long commutes, high pressure jobs, hurricane disruptions, and social isolation after relocation. We adapt treatment by:
- Offering telehealth check ins during demanding weeks,
- Creating commute decompression routines that lower stress before arriving home,
- Planning for shift work sleep problems,
- Ensuring medication and support continuity during weather emergencies.
Signs of progress
We measure:
- Fewer or less intense suicidal thoughts,
- Faster recovery from crisis spikes,
- Better sleep and appetite,
- Reconnection with work, school, and meaningful activities,
- Confidence in using safety plans and support earlier,
- A growing sense of hope and purpose.
A 12 week stabilization roadmap
- Weeks 1-2: Intake, safety plan, sleep plan, initial coping skills, possible medication start,
- Weeks 3-6: Therapy skills, CBT or DBT strategies, CAMS tracking, family session if helpful,
- Weeks 7-10: Refine coping strategies, medication adjustments, troubleshoot high risk times,
- Weeks 11-12: Relapse prevention, written early-warning checklist, holiday or anniversary planning.
This roadmap is flexible and adjusts based on progress.
FAQs – Suicidal Ideation in Houston and Richmond
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No. Talking openly decreases risk and builds trust.
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Not always. Many improve with therapy and safety planning. Medication is added when conditions like depression or bipolar disorder are present.
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Some patients notice relief within weeks, but lasting stability builds over months with steady therapy and support.
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Yes, with a strong safety plan and regular sessions. In person visits in Richmond are added when needed.
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Yes, with your consent. Family support can reduce risk and improve outcomes.
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Yes. They are considered when depression is resistant to standard treatments, always with close monitoring.
Why patients choose Cura Mind and Wellness
- Board certified expertise, leadership from a psychiatric nurse practitioner with crisis and mood disorder experience,
- Safety focused care, crisis planning, frequent follow up, and transparent decisions,
- Integrated options, therapy, medication management, gene testing, and advanced treatments,
- Local access, in person sessions in Richmond, telepsychiatry across Houston,
- Respectful environment, compassionate care that reduces stigma and restores hope.
Take the next step toward safety and stability
Suicidal thoughts are treatable signals that change is needed, not the end of the story. At Cura Mind and Wellness, we provide clear, compassionate treatment for patients across Houston, with in person care in Richmond and secure telehealth. Together, we will build a plan that prioritizes safety, respects your goals, and restores hope.